Myelodysplastic Syndromes as “Preleukemic States”

Abstract

Fourteen patients diagnosed as having myelodysplastic syndromes (MDS) according to the classification of the French-American-British Co-operative Group are described. These patients consisted of three cases of refractory anemia, seven cases of refractory anemia with excess of blasts, and four cases of refractory anemia with excess of blasts in transformation. Three of them died due to infection or hemorrhage in preleukemic states. Nine developed overt leukemia within 1 to 31 months (median, 13 months) after the time of diagnosis of MDS. Only one of six patients treated with chemotherapy achieved complete remission. Median survival time of nine patients who developed leukemia was 4 months from the of diagnosis of leukemia. This was not significantly different from that of 26 senile patients with acute nonlymphocytic leukemia without preceding preleukemic states. Our study indicates that patients with MDS are always exposed to dangers such as infection and hemorrhage, and that most of them develop overt leukemia refratory to chemotherapy, and the prediction of the development of leukemia is difficult.